Focal Liver Lesions

Abstract

State-of-the-art multidetector computed tomography (MDCT) and magnetic resonance (MR) imaging technologies offer detailed insights into the liver’s anatomy and the pathophysiology of liver disease, such that imaging has become the pacemaker in the development of new therapeutic techniques. Understanding different imaging techniques and the diagnostic potential of different modalities, including contrast utilization, is essential to optimize patient diagnoses. In the current environment of cost containment, the most appropriate modality should be chosen to answer the clinical question. Ultrasonography (US) is widely available, non-invasive, and the least expensive, but it is limited by low sensitivity and specificity unless US contrast agents are used. Instead, contrastenhanced CT has emerged as the modality of choice for routine liver imaging while MR imaging is used primarily as a problem-solving technique for liver evaluation when CT or US results are equivocal or if high concern exists for malignancy in certain high-risk populations. This chapter highlights the imaging of hepatic focal liver lesions, focusing on MDCT and MR imaging, but including ultrasonography in selected cases.